PSYCHONEUROIMMUNOLOGY AN APPROACH TO TEACHING HOMOEOPATHY

The purpose of the model is to draw together recent medical models and tie them in to our present homeopathic model together with esoteric and transpersonal models.

The present diagram in an upward direction can be regarded as a movement away from a relationship of function ( how things work) towards a relationship of meaning (why things work). Such a movement upwards draws us towards the realms of metaphor from Level 4 onwards, and into the infinite possibilities of belief structure with its equally infinite array of interpretations.

Nevertheless the purpose of this article is to focus on Level 2 with particular emphasis on the exciting field of Psychoneuro-immunology. (the field of Psychobiology I will leave to another article)

In trying to define the action of the vital force ( for example its response to a traumatic incident) from the moment of Cognitive appraisal (that is a mental process by which people assess a stress ) to a sustained attack on the health of the individual, it becomes clear that a dynamic interaction exists between the demands of the threat and whether their resources are available for meeting the demand. This discrepancy between demands and resources, whether real or otherwise, sets into motion a complex operation, through emotive cognitive processes which in turn have a knock-on effect on the mind/body complex via the Psycho-informative level, which is the information processing activity ( to use a computational metaphor) which occurs between the psychological - neurological - endocrinological and immunological systems.

This particular complex interaction between all these systems is now one of the fastest growing areas in the medical field and though still very much in its infancy, enough research has been done to tentatively link up all these different systems in the body. The Nervous, Endocrine and Immune systems can be regarded as the information highway between our consciousness and our bodily functions. It might even be referred to as the information mediator between mind and body.

Psycho-Informative Level of Interaction

This complex field of interactions represents the information processing network of the mind/body complex and is essential to a homoeopathic model since those symptoms elicited from the materia medica of any remedy must necessarily have to be processed through this entire network

Though I cannot hope to do justice to such a vast field in such a short article, I would like to at least give an overview of this fascinating field, to give a glimpse of just how intimate the relationship is between the psychological and immunological systems.

In 1929, Erich Wittkower published a paper in which he described his observations of pronounced increases in leucocyte numbers during different emotional states such as anxiety, rage, grief and joy. He postulated that this transient "Affektleukocytose" was due to a stimulation of the sympathetic nervous system which induced migration of leucocytes into the peripheral blood (Wittkower 1929).

This functional relationship between the sympathetic nervous system and the immune system was discussed as early as the beginning of this century. Different investigators observed pronounced increases in lymphocyte numbers in humans after injection of the neurotransmitter adrenaline, which had been discovered and produced synthetically a decade before (Hatiegan 1917, Friedberg 1920).

However, after the publication of studies conducted by Cannon and Selye, (1)both pioneers in stress research, work on the interactions between the nervous and immune system appeared to fall into oblivion and research focused instead on the effects of stress on endocrine variables, in particular adrenaline and corticoid secretions. It took more than 30 years until George F. Solomon published a paper entitled "Emotions, immunity, and disease: A speculative theoretical integration" in which he created the term "Psycho-immunology"(Solomon & Moos 1964).

It took another decade before the field became recognised when in 1981 Ader & Cohen (2)protagonists of Psychoneuroimmunology outlined an impressive amount of data showing the functional relationships between the nervous, endocrine and immunological systems.

What is essential to realise is that the homeopathic remedy must be acting as a bearer of information, and for the remedy to be effective, it must pass on this information to the network responsible for maintaining health in a changing environment. Such a network must not only be capable of processing information, but also be able to differentiate between self and non-self. Neurobiologist F. Varela (3) has referred to the immune system as the ‘second brain’ and has argued that the secret handshakes that enable antibodies to recognise ‘friend’ from ‘ foe’ also acts as overall basis for the sense of identity.

How the immune system can differentiate between self and non-self was firmly established by 1991(4) and was found to depend on a process of maturation that took place through the Thymus gland. It was found that the immature immune system produces cells that would attack every tissue in the body, so the question arose, how did the immune system recognise its own kind? The answer lay within the thymus which deleted and destroyed harmful cells, by exposing immature lymphocytes to self-peptides (special proteins associated with the recognition of self), and if these reacted antagonistically, they were destroyed, leaving only those that reacted to non-self proteins. These mature lymphocytes then became guardians of the overall sense of identity, implying that the immune system can perceive an internal image of its body constituents and react with alarming speed to any particular distortions of this image. Such an internal image then becomes a property of an integrated vision of the psychoneuro-immunological (PNI) network, and revives the essentially dynamic nature of the vital force, as quoted by Kent to be ‘endowed with formative intelligence, i.e., it intelligently operates and forms the economy of the whole organism’(5). Such ‘intelligence’ will largely be processed unconsciously by the PNI network since it has been estimated by computer scientists that unconscious data processing activity outnumbers the conscious rates by a factor of more than one trillion bits per second ( the latter is measure of the information rate)(6). It must be equally realised that in order to trace the formative economy of such a complex ecosystem, there has to be a constant and intimate interchange between conscious and unconscious appraisals of danger. To gain just how intimate such a relationship is, we can take the example of the octopus which can be likened to a naked nervous system, even a naked mind, since the octopus dances its thoughts through expressing itself in a series of colour changes, in other words, to behold is to understand.(7) In the same way the expression of thoughts is intricately embedded in the choreography of the immune system.

There is little doubt in anyone’s mind today that mental and emotional circuitry profoundly influence the physical and bodily functions of all organisms. The question has always been how, and only within the past two decades has hard evidence begun to accumulate in orthodox medicine over the self-evident holistic approaches of complementary medicines.

The evidence points towards an integrated circuitry that ties together the entire network so that the immune system appears to be modulated not only be feedback mechanisms mediated through the neural and endocrine processes but by feed-forward mechanisms which allow the immune system to have a profound effect on the workings of the brain.(8)

The immune system is built up of an enormous variety of interacting cells and molecules. The amount of information it can process and the different responses it can generate make it the most complex system after the CNS. (Central Nervous system)

At first glance, the CNS and the immune system have several characteristics in common. Both systems communicate at a distance (nerves impulses versus trafficking lymphocytes), are capable of developing memory (brain versus long lived memory lymphocytes) and both systems use chemicals to transfer messages (neurotransmitters/neuropeptides vs. Cytokines, these are names given to immune hormones). But one could even say that the immune system has one further level of complexity over that of the nervous system. The latter is fixed while the former is in a continuously mobile phase that would indicate that the functional plasticity of the immune system has to be far greater than that of the brain. For these reasons one researcher even raised the frivolous question whether the immune system is more ‘intelligent’ than the brain.(9)

What is clear is that the Immunological cells are specialised to detect altered patterns of self antigens (say a cancerous tumour) as well as to recognise micro-organisms and foreign macromolecules and particles. The immune system can be viewed as an extended organ with its cell components in strategically distributed parts of the body. Immune cells can bind antigens (foreign material) or participate in inflammatory reactions, which leads to the idea of effector cells (e.g. antibodies) that can interact with specific targets. However there is evidence that the information processed by the immune system can be transmitted to the CNS and the brain. Because of this capacity of receiving processing and sending information to the CNS, the immune system can be considered as a receptor sensorial organ.(10) In effect the communication between the nervous and immune system is bi-directional, and we can assume an incessant ‘cross talk’ between the two systems informing one another of the state of organism.

Today, we know that the interactions between the nervous-, endocrine and immune systems are complex and it is postulated that these systems communicate with each other over a biochemical network.

Since this is a short article, I will briefly comment on some of the findings that tie the psycho-neuro-endocrino-immune system together.

It was demonstrated that there was an increase in neuronal firing rates(electrical activity in the brain) in the anterior hypothalamus area at the time of a peak response during a response to immunisation . There is a large body of soviet literature which documents the electrophysiological alterations in brain activity during the course of a reaction to an antigen. Most important sites of such changes were found to be the hypothalamus (which controls the pituitary gland) and the limbic forebrain( where the emotional processing occurs). In other words it takes little time for the immune system to transfer information directly to the brain after a vaccination jab.

This particular organ plays a crucial role in the self/non self internal image of the body. Contrary to popular belief that thymic involution starts at puberty, the reduction in true thymic tissue starts as early as one year of age, and continues at a rate of approximately 3% per year until middle age, when it slows down to less than 1% per year.(12) It was shown that the thymus gland, produced neuropeptides that can stimulate the maturation of lymphocytes, and enhance antibody production. Furthermore they also were able to alter the activity of neuroendocrine circuits.

Thymosin increased secretion of ACTH Corticosteriods, Growth Hormone and Prolactin. It was also able to block the binding of corticosteriods to receptors on individual lymphocytes and directly influence the effects of the adrenal hormones, and thereby modulating the stress response.

3.Lymphocyte products.

(a) Neurohormones

The analysis of the immune system over the past 15 years in terms of the production of hormones and their receptors is beginning to reveal an important dimension to the immune system. The idea that lymphocyte produced hormones was established in 1980 but since then the number of hormones produced has increased to over 20.(13) In addition, they have been shown to have a substantial influence on certain immune functions, though they are thought to mainly act at the local level controlling basic aspects of the immune response. I will list some of the hormones capable of being produced by lymphocytes ACTH Thyrotropin (TSH) Luteinizing Hormone (LH), Follicle-stimulating Hormone (FSH), Growth Hormone (GH) Oxytocin etc. All studies show that cells of the immune system contain receptors for hormones and can also be considered a source of pituitary, hypothalamic and neural peptides. It is believed that such hormones both act as local regulators of the immune system, as well as conveyors of information to the neuroendocrine system (14)

(b)Cytokines

These are chemical messengers (immune hormones) secreted by lymphocytes which mediate between the immune system and the CNS. They were originally thought to be exclusive to the immune system but recent research has shown that cells in several regions of the brain and CNS have receptor sites for them.(15) When cytokines are released by activated immune cells they can have widespread effects on the neuroendocrine circuits and psychological states of the organism. For example when an infection occurs, the cytokine Interleukin-1 (IL-1) acts on the brain to induce slow-wave sleep and loss of appetite; IL-1 acting in concert with Interleukin-6 (IL-6) induces fever by modulating the temperature control centres in the brain. Cytokines are also active within the endocrine system and are all capable of influencing the release of hormones by the pituitary and adrenal glands.

Interferons, another type of cytokine with specific anti-viral activity can act as neuromodulators. They have been shown to alter the electrical activity of central neurons in several parts of the brain. Even more interestingly some researchers found high levels of interferon in the serum of psychotic patients.(16)

This remarkable phenomenon shows that the immune system can learn, by association, to respond to psychological stimuli such as a novel taste or smell. In other words, the immune system can learn to respond to, say the smell of coffee in much the same way that it would respond to a powerful immune-suppressive drug. Ader and Cohen were studying a special form of behavioural conditioning called learned taste aversion. They gave rats sweetened water and then injected with a drug called cyclophosphamide to make them nauseous. The rats soon learned to avoid the sweet water through Pavlovian conditioning, because it made them sick. But then the rats started to die in large numbers, the more sweet water they drank the more likely they were to die.

The question was how could sweet water make a rat die? Ader and Cohen also knew that the drug given to make the rats nauseous, was also a powerful immune suppressant. They therefore concluded that a form of conditioning must have occurred in which the neutral stimulus (sweet water) had come to elicit the same biological response as the drug, namely immune suppression. Since this ground breaking experiment in the 1970’s the finding that changes in the immune function can be conditioned and subsequently evoked by psychological stimuli has been replicated again and again. Not only can immune conditioning modify immune function but it has also been shown to produce measurable changes in health and alter the progress of such diseases as cancer and arthritis. The implications of such conditioning indicates that the immune system may well function in not dissimilar ways to our own psychological appraisals of situations, and may run concurrently with or even override our most intimate assessments of current situations. Furthermore evidence has been found that even mere sight, smell or thought of a hospital can lead to immune suppression,(18) which leads to questions of how the immune system, placebo and the psychology of positive imagery can have potents effects on the health of the individual.

In effect all this data provides hard evidence that we must start to consider just how embodied the mind is, and how fundamental the constant interchange between all the systems must be to maintain the overall identity and health of the individual. It is equally important to consider how such insights of this complex network can brought to bear on the homoepathic activity of individual remedies. The subtle but dramatic changes that can occur after the administration of a remedy can also be traced out in its action on the neuroendocrine and psychoimmunological systems. We will be able to understand in much more detail how the so called ‘vital force’ is able to influence and directly change the health of an organism.

To take an example, an empirical observation in treating small babies is the problems of sometimes finding a remedy , and so recourse is taken to observing and asking questions about the pregnancy and its circumstances. This obvious ploy has been documented clearly in the effects of stress on the immune system and a number of studies have shown how certain cells of the immune system are permanently changed by the circumstances of external stressors in pregnancy. Such early traumatic events which can alter the concentrations of receptors on lymphocytes may have an effect on the ability of the infant in later life to deal with stress.(19)

I have only been able to give a brief glimpse of a fascinating subject that should in my mind become an essential aspect of any teaching module to do with complementary medicine, since it represents enormous inroads into a medicine of the whole organism.

[1] Selye, H., (1956). The Stress of Life. New York, Toronto, London: McGraw-Hill Book Co., Inc.